Nilgun USTUN, Alper ULAŞLI, İhsan ÜSTÜN, Erkan YULA, Abdullah Erman YAĞIZ, Hayal GÜLER

Mean Platelet Volume Level in Patients with Ankylosing Spondylitis and its Relationship with Disease Activity and Presence of Cardiovascular Risk Factors

Bu çalışma, sağlıklı kontrollerle ile ankilozan spondilit (AS) hastalarda ortalama trombosit hacmini (MPV) karşılaştırmak, hastalık durumu ile sigara, hipertansiyon, hiperlipidemi, diyabet ve obezite gibi geleneksel kardiyovasküler risk faktörleri (KBY) varlığının etkisini analiz etmek için yapılmıştır. Retrospektif olarak AS'li 152 hasta çalışmaya alındı. Kontrol grubu olarak herhangi bir risk faktörleri ve eşlik eden hastalıkları olmayan, cinsiyet ve yaşları eşleştirilmiş 55 sağlıklı kişi alındı. AS hastalarının MPV düzeyleri kontrol grubundan yüksekti. En az bir geleneksel kardiyovasküler risk taşıyan AS hastalarında MPV ve PLT düzeyleri sağlıklı kontrol grubu ile karşılaştırıldığında anlamlı farklılık yoktu. MPV herhangi bir hastalık aktivitesi ile anlamlı ilişki göstermedi. MPV aktif ve inaktif duruma göre AS hastalarında anlamlı farklılık bulunmadı. Hastalar kardiyovasküler tutulum ve ateroskleroz riski daha yüksek olan kontrol grubuna göre daha yüksek MPV değerine sahipti. AS tek başına geleneksel kardiyovasküler risk faktörlerinden bağımsız olarak bu artıştan olabilir

Anahtar Kelimeler:

Ankilozan spondilit, ortalama platelet hacmi, kardiyovaskuler hastalık, hastalık aktivitesi

Mean Platelet Volume Level in Patients with Ankylosing Spondylitis and its Relationship with Disease Activity and Presence of Cardiovascular Risk Factors

This study was conducted to compare mean platelet volume (MPV) in ankylosing spondylitis (AS) patients with that of healty controls, analyze the effect of disease status and presence of traditional cardiovascular risk factors (CRF) such as smoking, hypertension, hyperlipidemia, diabetes and obesity. Retrospectively, 152 patients with AS were included. The control group included 55 sex-and age-matched healty subjects without any risk factors and concomitant diseases. MPV level in AS patients was higher than healthy controls, MPV and PLT levels in AS patients with at least on one traditional CRF were not significantly different compared to patients without any risk factor. MPV showed no significant association with any disease activity. There was no significant difference between active and inactive state in AS patients according to MPV. Patients have higher MPV than healthy controls indicating higher risk of cardiovascular involvement and atherosclerosis. AS alone may be responsible of this increment instead of traditional CRF\'s.

Keywords:

ankylosing spondylitis, mean platelet volume, cardiovascular disease, disease activity,

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Bodnár N, Kerekes G, Seres I, et al. Assessment of sub- clinical vascular disease associated with ankylosing spon- dylitis. J Rheumatol 2011;38:723-9.
Peters MJ, van Eijk IC, Smulders YM, et al. Signs of accel- erated preclinical atherosclerosis in patients with anky- losing spondylitis. J Rheumatol 2010;37:161-6.
Han C, Robinson DW Jr, Hackett MV, Paramore LC, Fraeman KH, Bala MV. Cardiovascular disease and risk factors in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis. J Rheumatol 2006;33:2167–72.
Heeneman S, Daemen MJ. Cardiovascular risks in spondy- loarthritides. Curr Opin Rheumatol 2007;19:358-62.
Peters MJ, Van Der Horst-Bruinsma IE, Dijkmans BA, Nurmohamed MT. Cardiovascular risk profile of patients with spondylarthropathies, particularly ankylosing spon- dylitis and psoriatic arthritis. Semin Arthritis Rheum 2004;34:585-92.
Van Halm VP, Van Denderen JC, Peters MJ, et al. Increased disease activity is associated with a deteriorated lipid profile in patients with ankylosing spondylitis. Ann Rheum Dis 2006;65:1473-7
Papadakis JA, Sidiropoulos PI, Karvounaris SA, et al. High prevalence of metabolic syndrome and cardiovascular risk factors in men with ankylosing spondylitis on anti-TNFal- pha treatment: correlation with disease activity. Clin Exp Rheumatol 2009;27:292-8.
Caliskan M, Erdogan D, Gullu H, et al. Impaired coronary microvascular and left ventricular diastolic functions in patients with ankylosing spondylitis. Atherosclerosis 2008;196:306-12.
Weyrich AS, Lindemann S, Zimmerman GA. The evolv- ing role of platelets in inflammation. J Thromb Haemost 2003;1:1897–905.
Elsenberg EH, van Werkum JW, van de Wal RM, et al. The influence of clinical characteristics, laboratory and in- flammatory markers on ‘high on-treatment platelet reac- tivity’ as measured with different platelet function tests. Thromb Haemost 2009;102:719-27.
Toplak H, Wascher TC. Cardiovascular risk factors in obe- sity. Influence of weight reduction on platelet volume: Different effects of hypocaloric diet and a very low calo- riediet. Eur J Clin Invest 1994;24:778–80.
Pereg D, Berlin T, Mosseri M. Mean platelet volume on ad- mission correlates with impaired response to thromboly- sis in patients with ST-elevation myocardial infarction. Platelets 2010;21:117-21.
Martin JF, Bath PM, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet 1991;338:1409-11.
Bath P, Algert C, Chapman N, et al. PROGRESS Collaborative Group. Association of mean platelet vol- ume with risk of stroke among 3134 individuals with his- tory of cerebrovascular disease. Stroke 2004;35:622-6.
Yazici S, Yazici M, Erer B, et al. The platelet indices in pa- tients with rheumatoid arthritis: mean platelet volume reflects disease activity. Platelet 2010;21:122-5.
Canpolat F, Akpinar H, Eskioğlu F. Mean platelet vol- ume in psoriasis and psoriatic arthritis. Clin Rheumatol 2010;29:325-8.
Zuberi BF, Akhtar N, Afsar S. Comparison of mean platelet volume in patients with diabetes mellitus, impaired fast- ing glucose and non-diabetic subjects. Singapore Med J 2008;49:114-6.
Cao X, Xie X, Zhou J, Yang P, Wang Y, Chen Z. Increased platelet volume in a general population with prehyper- tension: a cross-sectional study of 80 545 participants from China. Hypertens Res 2012;35:903-8.
Varol E, Akcay S, Icli A, et al. Mean platelet volume in patients with prehypertension and hypertension. Clin Hemorheol Microcirc 2010;45:67-72.
Coban E, Afacan B. The effect of rosuvastatin treat- ment on the mean platelet volume in patients with un- controlled primary dyslipidemia with hypolipidemic diet treatment. Platelets 2008;19:111-4.
Coban E, Yilmaz A, Sari R. The effect of weight loss on the mean platelet volume in obese patients. Platelets 2007;18:212-6.
Varol E, Icli A, Kocyigit S, Erdogan D, Ozaydin M, Dogan A. Effect of smoking cessation on mean platelet volume. Clin Appl Thromb Hemost 2013;19:315-9.
Acikgoz N, Karincaoğlu Y, Ermiş N, et al. Increased mean platelet volume in Behçet’s Disease with thrombotic ten- dency. Tohoku J Exp Med 2010;221:119-23.
Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflam- mation? Curr Pharm Des 2011;17:47-58.
Jurcuţ C, Jurcuţ R, Caraiola S, et al. Platelet histogram indices and cardiovascular disease in patients with rheu- matoid arthritis. Rom J Intern Med 2010;48:51-5.
Kisacik B, Tufan A, Kalyoncu U, et al. Mean platelet volume (MPV) as an inflammatory marker in ankylosing spondylitis and rheumatoid arthritis. Joint Bone Spine 2008;75:291-4.
van der Linden S, Valkenburg HA, Cats A. Evaluation of diagnostic criteria for ankylosing spondylitis. A proposal for modification of the New York criteria. Arthritis Rheum 1984;27:361-8.
Kutlucan A, Bulur S, Kr S, et al. The relationship between mean platelet volume with metabolic syndrome in obese individuals. Blood Coagul Fibrinolysis 2012;23:388-90.
Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: methodological issues. Platelets 2002;13:301-6.
Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost 2010;8:148-56.